Asthenia is a clinical syndrome that can be manifest in almost all somatic, infectious, and neurological diseases. Initially a protective mechanism indicating depletion of energy resources, asthenia can become a pathological and extremely disabling condition, and can even progress to an independent immune-mediated disease – chronic fatigue syndrome. Asthenia is often combined with affective and cognitive disorders, producing diagnostic difficulties. The article addresses the complex interweaving of asthenia, chronic fatigue syndrome, and cognitive and affective disorders.
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L. Bateman, A. C. Bested, H. F. Bonilla, et al., “Myalgic encephalomyelitis/chronic fatigue syndrome: essentials of diagnosis and management,” Mayo Clin. Proc., 96, No. 11, 2861–2878. https://doi.org/10.1016/j.mayocp.2021.07.004 (2021).
I. M. Gandasegui, L. A. Laka, P. Á. Gargiulo, et al., “Myalgic encephalomyelitis/chronic fatigue syndrome: A neurological entity?” Medicina (Kaunas), 57, No. 10, 1030 (2021), https://doi.org/10.3390/medicina57101030.
T. L. Wong and D. J. Weitzer, “Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – A systemic review and comparison of clinical presentation and symptomatology,” Medicina (Kaunas), 57, No. 5, 418 (2021), https://doi.org/10.3390/medicina57050418.
U. S. Deumer, A. Varesi, V. Floris, et al., “Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), An overview,” J. Clin. Med., 10, No. 20, 4786 (2021), https://doi.org/10.3390/jcm10204786.
A. L. Komaroff, “Myalgic encephalomyelitis/chronic fatigue syndrome: When suffering is multiplied,” Healthcare (Basel), 9, No. 7, 919 (2021), https://doi.org/10.3390/healthcare9070919.
M. Venus and M. G. Holtforth, “Short and long haul pilots rosters, stress, sleep problems, fatigue, mental health, and well-being,” Aerosp. Med. Hum. Perform., 92, No. 10, 786–797 (2021), https://doi.org/10.3357/AMHP.5812.2021.
H. Ormstad, C. S. Simonsen, L. Broch, et al., “Chronic fatigue and depression due to multiple sclerosis: Immune-inflammatory pathways, tryptophan catabolites and the gut-brain axis as possible shared pathways,” Mult. Scler. Relat. Disord., 46, 102533 (2020), https://doi.org/10.1016/j.msard.2020.102533.
E. E. Vasenina, N. I. Veryugina, and O. S. Levin, “Postinfection asthenia and COVID-19,” Terapiya, 9, No. 51, 125–136 (2021), https://doi.org/10.18565/therapy.2021.9.125-136.
G. M. Slavich and M. R. Irwin, “From stress to inflammation and major depressive disorder: a social signal transduction theory of depression,” Psychol. Bull., 140, No. 3, 774–815 (2014), https://doi.org/10.1037/a0035302.
S. J. Yong, “Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments,” Infect. Dis. (Lond.), 53, No. 10, 737–754 (2021), https://doi.org/10.1080/23744235.2021.1924397.
F. J. Carod-Artal, “Post-COVID-19 syndrome: epidemiology, diagnostic criteria and pathogenic mechanisms involved. Síndrome post-COVID-19: epidemiología, criterios diagnósticos y mecanismos patogénicos implicados,” Rev. Neurol., 72, No. 11, 384–396 (2021), https://doi.org/10.33588/rn.7211.2021230.
W. J. Song, C. K. M. Hui, J. H. Hull, et al., “Confronting COVID-19-associated cough and the post-COVID syndrome: role of viral neurotropism, neuroinflammation, and neuroimmune responses,” Lancet Respir. Med., 9, No. 5, 533–544 (2021), https://doi.org/10.1016/S2213-2600(21)00125-9.
M. Ruiz-Pablos, B. Paiva, R. Montero-Mateo, et al., “Epstein-Barr virus and the origin of myalgic encephalomyelitis or chronic fatigue syndrome,” Front. Immunol., 12, 656797 (2021), https://doi.org/10.3389/fimmu.2021.656797.
A. D. Proal and M. B. VanElzakker, “Long COVID or post-acute sequelae of COVID-19 (PASC): An overview of biological factors that may contribute to persistent symptoms,” Front. Microbiol., 12, 698169 (2021), https://doi.org/10.3389/fmicb.2021.698169.
U. Tirelli, R. Taibi, and S. Chirumbolo, “Post COVID syndrome: a new challenge for medicine,” Eur. Rev. Med. Pharmacol. Sci., 25, No. 12, 4422–4425 (2021), https://doi.org/10.26355/eurrev_202106_26154.
K. A. Scordo, M. M. Richmond, and N. Munro, “Post-COVID-19 syndrome: Theoretical basis, identification, and management,” AACN Adv. Crit. Care, 32, No. 2, 188–194 (2021), https://doi.org/10.4037/aacnacc2021492.
E. F. W. Raanes and T. C. Stiles, “associations between psychological and immunological variables in chronic fatigue syndrome/myalgic encephalomyelitis: A systematic review,” Front. Psychiatry, 12, 716320 (2021), https://doi.org/10.3389/fpsyt.2021.716320.
V. Menzies, D. L. Kelly, G. S. Yang, et al., “A systematic review of the association between fatigue and cognition in chronic noncommunicable diseases,” Chronic Illn., 17, No. 2, 129–150 (2021), https://doi.org/10.1177/1742395319836472.
X. Li, P. Julin, and T. Q. Li, “Limbic perfusion is reduced in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS),” Tomography, 7, No. 4, 675–687 (2021), https://doi.org/10.3390/tomography7040056.
A. Nkiliza, M. Parks, A. Cseresznye, et al., “Sex-specific plasma lipid profiles of ME/CFS patients and their association with pain, fatigue, and cognitive symptoms,” J. Transl. Med., 19, No. 1, 370 (2021), https://doi.org/10.1186/s12967-021-03035-6.
J. B. Badenoch, E. R. Rengasamy, C. Watson, et al., “Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis,” Brain Commun., 4, No. 1, fcab297 (2021), https://doi.org/10.1093/braincomms/fcab297.
M. R. Zielinski, D. M. Systrom, and N. R. Rose, “Fatigue, sleep, and autoimmune and related disorders,” Front. Immunol., 10, 1827 (2019), https://doi.org/10.3389/fimmu.2019.01827.
G. Morris and M. Maes, “Myalgic encephalomyelitis/chronic fatigue syndrome and encephalomyelitis disseminata/multiple sclerosis show remarkable levels of similarity in phenomenology and neuroimmune characteristics,” BMC Med., 11, 205 (2013), https://doi.org/10.1186/1741-7015-11-205.
J. A. Glassford, “The neuroinflammatory etiopathology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS),” Front. Physiol., 8, 88 (2017), https://doi.org/10.3389/fphys.2017.00088.
K. J. Wirth, C. Scheibenbogen, and F. Paul, “An attempt to explain the neurological symptoms of myalgic encephalomyelitis/chronic fatigue syndrome,” J. Transl. Med., 19, No. 1, 471 (2021), https://doi.org/10.1186/s12967-021-03143-3.
P. Wostyn and P. P. De Deyn, “The putative glymphatic signature of chronic fatigue syndrome: A new view on the disease pathogenesis and therapy,” Med. Hypotheses, 118, 142–145 (2018), https://doi.org/10.1016/j.mehy.2018.07.007.
N. J. Abbott, M. E. Pizzo, J. E. Preston, et al., “The role of brain barriers in fluid movement in the CNS: is there a ‘glymphatic’ system?” Acta Neuropathol., 135, No. 3, 387–407 (2018), https://doi.org/10.1007/s00401-018-1812-4.
H. Benveniste, H. Lee, and N. D. Volkow, “The glymphatic pathway: Waste removal from the CNS via cerebrospinal fluid transport,” Neuroscientist, 23, No. 5, 454–465 (2017), https://doi.org/10.1177/1073858417691030.
T. Nelson, L. X. Zhang, H. Guo, et al., “Brainstem abnormalities in myalgic encephalomyelitis/chronic fatigue syndrome: A scoping review and evaluation of magnetic resonance imaging findings,” Front. Neurol., 12, 769511 (2021), https://doi.org/10.3389/fneur.2021.769511.
K. Thapaliya, S. Marshall-Gradisnik, D. Staines, and L. Barnden, “Diffusion tensor imaging reveals neuronal microstructural changes in myalgic encephalomyelitis/chronic fatigue syndrome,” Eur. J. Neurosci., 54, No. 6, 6214–6228 (2021), https://doi.org/10.1111/ejn.15413.
K. Thapaliya, S. Marshall-Gradisnik, D. Staines, and L. Barnden, “Mapping of pathological change in chronic fatigue syndrome using the ratio of T1- and T2-weighted MRI scans,” NeuroImage Clin., 28, 102366 (2020), https://doi.org/10.1016/j.nicl.2020.102366.
Z. Y. Shan, R. Kwiatek, R. Burnet, et al., “Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study,” J. Magn. Reson. Imaging, 44, No. 5, 1301–1311 (2016), https://doi.org/10.1002/jmri.25283.
N. Noor, I. Urits, A. Degueure, et al., “A comprehensive update of the current understanding of chronic fatigue syndrome,” Anesth. Pain Med., 11, No. 3, e113629 (2021), https://doi.org/10.5812/aapm.113629.
S. Richman, M. C. Morris, G. Broderick, et al., “Pharmaceutical interventions in chronic fatigue syndrome: A literature-based commentary,” Clin. Ther., 41, No. 5, 798–805 (2019), https://doi.org/10.1016/j.clinthera.2019.02.011.
C. X. Sandler and A. R. Lloyd, “Chronic fatigue syndrome: progress and possibilities,” Med. J. Aust., 212, No. 9, 428–433 (2020), https://doi.org/10.5694/mja2.50553.
X. Che, C. R. Brydges, Y. Yu, et al., “Evidence for peroxisomal dysfunction and dysregulation of the cdp-choline pathway in myalgic encephalomyelitis/chronic fatigue syndrome. Preprint,” medRxiv, 2022.2021.06.14.21258895 (2022), https://doi.org/10.1101/2021.06.14.21258895.
C. Vila-Castelar, J. J. Ly, L. Kaplan, et al., “Attention measures of accuracy, variability, and fatigue detect early response to donepezil in Alzheimer’s disease: A randomized, double-blind, placebo-controlled pilot trial,” Arch. Clin. Neuropsychol., 34, No. 3, 277–289 (2019), https://doi.org/10.1093/arclin/acy032.
M. De Jesus Moreno Moreno, “Cognitive improvement in mild to moderate Alzheimer’s dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial,” Clin. Ther., 25, No. 1, 178–193 (2003), https://doi.org/10.1016/s0149-2918(03)90023-3.
S. I. Gavrilova, A. V. Alesenko, and I. V. Kolykhalov, et al., “Clinical and biological effects of Cereton in the treatment of amnestic mild cognitive impairment,” Psikhiatriya, 73, No. 1, 5–15 (2017).
Yu. A. Starchina, “Use of Cereton in neurological practice,” Nevrol. Neiropsikh. Psikhosom., 2, 81–85 (2011).
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Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 122, No. 5, Iss. 1, pp. 23–29, May, 2022.
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Vasenina, E.E., Gankina, O.A. & Levin, O.S. Stress, Asthenia, and Cognitive Disorders. Neurosci Behav Physi 52, 1341–1347 (2022). https://doi.org/10.1007/s11055-023-01364-1
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DOI: https://doi.org/10.1007/s11055-023-01364-1